Death by suicide is the 10th-leading cause of death in the United States, according to the American Foundation for Suicide Prevention. The foundation estimates approximately 45,000 Americans die by suicide each year — that’s an average of 123 suicides per day. These numbers, however, are thought to be much higher.

Despite the high rate of death by suicide among Americans, roughly 40 percent of people with a mental health condition don’t receive medical attention, estimates a 2014 review. Researchers found that stigma is one of the leading reasons why people don’t seek help.

If you or someone you know is considering suicide, know you’re not alone and help is out there. Below is a resource guide that includes hotlines, online forums, and other methods of support.

When people are having thoughts of harming themselves, suicide prevention hotlines can make all the difference. Crisis hotlines help millions of people every year and offer the option to speak with trained volunteers and counselors, either via phone or text message.

988 Suicide and Crisis Lifeline

The 988 Suicide and Crisis Lifeline is a national network of more than 150 local crisis centers. It offers free and confidential support around the clock to those experiencing a suicidal crisis.

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Crisis Text Line

The Crisis Text Line is a free text messaging resource offering 24/7 support to anyone in crisis. Since August 2013, more than 79 million text messages have been exchanged.

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The Trevor Project

The Trevor Project offers crisis intervention and suicide prevention to LGBTQ youth through its hotline, chat feature, text feature, and online support center.

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The Veterans Crisis Line

The Veterans Crisis Line is a free, confidential resource staffed by qualified responders from the Department of Veterans Affairs. Anyone can call, chat, or text — even those not registered or enrolled with the VA.

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SAMHSA’s National Helpline (Substance Abuse)

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) national helpline offers confidential treatment referrals in both English and Spanish to people struggling with mental health conditions, substance use disorders, or both. In the first quarter of 2018, the helpline received more than 68,000 calls every month.

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People who call suicide hotlines may hang up as soon as their call is answered. Online networks and support groups offer millions of people in crisis an alternative to asking for help out loud.

IMAlive

IMAlive is a virtual crisis center. It offers volunteers who are trained in crisis intervention. These individuals are ready to instant message with anyone who needs immediate support.

BetterHelp

This resource connects people with licensed, professional therapists online for a low, flat fee. Therapy is available whenever you need it.

7 Cups of Tea

7 Cups is an online resource that offers free, anonymous, and confidential text chat with trained listeners and online therapists and counselors. With over 28 million conversations to date, it’s the world’s largest emotional support system.

ADAA Online Support Group

With more than 18,000 subscribers worldwide, the Anxiety and Depression Association of America’s online support group is a safe, supportive place to share information and experiences.

Befrienders

Befrienders is a global network of 349 emotional support centers around the world. It offers an open space for anyone in distress to be heard. Support is available via telephone, text message, in person, online, and through outreach and local partnerships.

Worldwide Suicide Prevention Chats

A source of emergency numbers, online chats, suicide hotlines, and therapy options, Suicide Stop gives people a variety of support methods.

Self-Injury Outreach and Support

Self-Injury Outreach and Support is an international outreach organization offering a variety of resources for those who self-injure, including guides, stories, and methods for day-to-day coping.

According to the National Institute of Mental Health, it’s often family and friends who first notice warning signs of suicide in their loved ones. Recognizing these signs can be the first step toward helping an at-risk individual find the support and guidance they need. The following apps, resources, and forums can help.

THRIVE app

The Thrive app is designed by the Society for Adolescent Health and Medicine. It helps guide parents in starting important dialogue with their teenage children on a variety of health and wellness topics.

Society for the Prevention of Teen Suicide

This online resource helps parents and educators raise awareness about youth suicide and attempted suicide through the development and promotion of educational training programs. The site also offers resources for teenagers who are contemplating suicide.

Jed Foundation

The Jed Foundation (JED) is a nonprofit organization that exists to protect the emotional health and prevent suicide of our nation’s teens and young adults. JED equips these individuals with the skills and knowledge to help themselves and each other, and encourages community awareness, understanding, and action for young adult mental health. The organization also partners with high schools and colleges to strengthen their mental health, substance use, and suicide prevention programs and systems.

National Alliance on Mental Illness Resource

Helping a loved one with mental illness can be challenging, but knowing where to begin is an important first step. The National Alliance on Mental Illness offers family members and caregivers specific guidance on a variety of issues, including how to help prevent suicide.

Mayo Clinic

The Mayo Clinic’s guide on how to support a loved one who’s dealing with depression includes how to identify symptoms and warning signs, seek treatment, and find local resources.

Teen Health

This online resource helps parents decide whether their child’s behavior is just a phase or a sign of something more serious.

Kelty Mental Health Resource Center

Parents and caregivers can find a variety of information and resources relating to mental health issues affecting children and young adults at the Kelty Mental Health Resource Center.

To Write Love on Her Arms

This nonprofit aims to help people struggling with depression, addiction, self-injury, and suicide by connecting them with the appropriate hotlines, resources, and online communities through its blog and social channels. The organization also fundraises to directly invest into treatment and recovery programs.